Information Collection

National Survey of Victim Service Providers Cognitive Testing

IC 227963 under ICR 201512-1121-004 · OMB 1121-0339.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0339 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
National Survey of Victim Service Providers Cognitive Testing	Form and Instruction
NSVSP instrument for VSPs serving victims as their prima NSVSP Cog testing Draft instrument A.docx	Form and Instruction
NSVSP instrument for VSPs serving victims through dedica NSVSP Cog testing Draft instrument B.docx	Form and Instruction
NSVSP OMB Memo - Cognitive Testing.docx NSVSP Cognitive Testing Memo	IC Document
NSVSP OMB attachments_CogTesting.docx NSVSP Cog Testing Attachments	IC Document

IC Title:

National Survey of Victim Service Providers Cognitive Testing

Agency IC Tracking Number:

BJS

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	NSVSP instrument for VSPs serving victims as their primary function	NSVSP Cog testing Draft instrument A.docx		No		Paper Only
Form and Instruction	N/A	NSVSP instrument for VSPs serving victims through dedicated staff or programs (Secondary VSPs)	NSVSP Cog testing Draft instrument B.docx		No		Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	30	30
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
NSVSP Cognitive Testing Memo	NSVSP OMB Memo - Cognitive Testing.docx	08/18/2017
NSVSP Cog Testing Attachments	NSVSP OMB attachments_CogTesting.docx	08/18/2017

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.